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No state has fallen further than Kansas in America’s Health Rankings. We used to be 8th in 1991.
Why did we slip so far down in the rankings? The answer might surprise you; it’s based on a leadership challenge.
At the Kansas Health Foundation, our bold vision is to make Kansas the healthiest state in the nation and to do so, this movement must be powered by Kansans in positions of authority and influence to shift Health outcomes.
Starting with the launch of the 2025 publication, Leading Health, written by President and CEO of the Kansas Health Foundation, Ed O’Malley, this podcast aims to break down key concepts of this leadership challenge and actionable ways that we can work together to make a real impact on Health in Kansas.
In each episode, Ed O’Malley, and Senior Advisor at Kansas Health Foundation, Susan Kang, will highlight a chapter in the book and discuss with Kansans who are actively engaged in expanding our definition of Health.
Leading Health is an invitation to move the needle on Health in Kansas, and we invite you to join us in leading the way.
Ep12
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The ‘Upstream’ Mindset
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[00:00:00]
Ed O'Malley: Welcome to another episode of the Leading Health Podcast. Today we're focusing on chapter 12 in the book. Susan. Good to be with you again.
Susan Kang: Great to be here. Ed,
Ed O'Malley: big big topic [00:01:00] today.
The topic is the first of the nine mindsets, so the, that's part three of the book is all about these mindsets. We need people in authority, the 30,000 to hold, and this first one is the mindset of working. Upstream. So we're gonna get into that conversation today. We're gonna paint the picture of what the chapter talks about, and then in a little while, we're gonna be joined by Teresa Lovelady again, who has happened to be our last guest.
Yeah. We had on, which was two episodes ago. So we're excited to have her join us again. But before we do that.
Charity vs. Change: Why Band-Aids Aren’t Enough
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Ed O'Malley: Let me describe this chapter. So the chapter starts by the fact that the first line is pretty provocative. It's a question that says, do we need charity or change?
Susan Kang: Mm-hmm.
Ed O'Malley: The answer of course is we need both.
Getting the balance right is the challenge, and later on I go on to say that Kansans are really good at charity. Like charity is [00:02:00] great. Like we need people to be charitable. Yeah. But I also go to great lengths in the chapter say that, but charity doesn't change things like charity treats, symptoms.
Susan Kang: Mm-hmm.
Ed O'Malley: It doesn't cure things.
Susan Kang: Right. It's the bandaid.
Ed O'Malley: It's the bandaid. Mm-hmm. We gotta keep putting bandaids. But we need to go beyond that. And I actually talk about how Kansas, like one of our strengths is charity. We rank seventh in volunteerism. Right? Right. Which is one of the submeasures that make up America's health rankings.
And that spirit of volunteerism, I think, flows into our charitable disposition, which we have to keep doing. And. We gotta get people thinking upstream, which is not charitable thinking, charity's, downstream.
The ‘Babies in the River’ Story: What Upstream Really Means
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Ed O'Malley: So, okay, so what do we mean by upstream? Susan, you and I have used this example a lot, but it might be new for some people.
So the story we tell in the book, the little [00:03:00] story that I don't know who came up with the story, but I've heard it a gazillion times, is that, once upon a time there were people living in a village along a river and one day they start to see babies floating down the river.
Susan Kang: Yeah.
Ed O'Malley: And these people in the village were, were just horrified.
This is, this is awful. This is scary. And so they quickly began to dive in and save the babies, but the babies kept coming and these are good people in this village, and so they. Quickly organized themselves and they devised systems and structures and processes to make sure that every baby that was floating down the river could be rescued.
And it was a massive operation. Right.
Susan Kang: So much work.
Ed O'Malley: So much work. Mm-hmm. Mm-hmm. And everybody was doing their part. And everybody knew the work had to continue, but there was this one woman and one day after her shift of doing her part to pull babies out of the river, she started walking up the river.
And picture the moment, right? [00:04:00] Like the whole system is working to save these babies, right? And she starts walking up the river and picture her husband yelling after her. Like, what are you doing? Where are you going? We're saving babies here. Like, and. She's able to hold two thoughts at once.
She's able to say, on one hand, we gotta keep saving these babies. Right. But on the other hand, I gotta go up river and figure out who the heck is throwing the babies in the
Susan Kang: river. Yeah. Yeah.
Ed O'Malley: I gotta I there.
Susan Kang: Yeah. Right. What is happening upstream?
Ed O'Malley: So that's what we're talking about with this chapter. That's the mindset we're trying to help people in authority think about, right?
Susan Kang: Right.
Ed O'Malley: That we need more people in authority, understanding we have to keep delivering the charity. But we have to also get further upstream. We need more interventions, more activity that is further upstream.
Real-World Upstream Examples: Foster Care & Workplace Wellness
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Ed O'Malley: So a couple quick examples and then let's get our friend Teresa into this conversation with us.
But you know, a pastor who's been on the [00:05:00] front lines of encouraging people to adopt foster kids. Imagine that pastor dedicating a four-part sermon series to exploring changes in society in the church that would be necessary so fewer kids would ever enter foster care in the first place. Like that's an example, right?
Of like that sermon series is further upstream than a sermon about we should all go adopt foster kids. Both are needed, but they're different. Right. Or yeah. A, an another example, you know, ACEC, EO of a large company champions a wellness plan that focuses on financial, emotional and inter interpersonal health.
The CEO has witnessed that when those. Upstream wellness factors, this is in the book, are out of balance. Her employees tend to need help with downstream issues like depression, substance abuse, stress, and anxiety. So like her that CEO, initiating that [00:06:00] wellness plan is an upstream effort. Not a downstream effort.
Make sense?
Susan Kang: Yeah. 100%. I mean, I think it is, really important to make that sort of distinction between downstream work and like putting band-aids on. So treating the symptoms and going upstream where you're looking at identifying what the cause of those symptoms are in the first place.
Ed O'Malley: So that's the chapter.
Guest Joins: Teresa Lovelady Returns to Talk Practice, Not Theory
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Ed O'Malley: Let's bring Teresa into the conversation and really paint a picture of what this looks like in practice.
Susan Kang: I can't wait.
Ed O'Malley: Teresa, welcome back.
Teresa Lovelady: Well, it's great to be back.
Ed O'Malley: We love having you as part of this podcast. Thanks for being one of the conversation Catalyst. This is your third time with us. You were with us way back when on episode two.
Teresa Lovelady: Yes. Yes, yes.
Ed O'Malley: And then just a few weeks ago on episode.
Teresa Lovelady: It was the Alice episode and then Yes.
The first one.
Susan Kang: Yeah. So that's episode 11,
Teresa Lovelady: and then we're, yeah, 11 and now we're at
Susan Kang: 12.
Ed O'Malley: yeah. Wow. Chapter 12 now. Yeah. Love it. So let's dive in. Susan. How should we start?
Susan Kang: So you've had a chance to read the. Chapter, obviously read the book probably multiple times. I [00:07:00] know I have. Yeah, me too.
So I just, I mean, I just, I really think that it's, you know, as Ed explained, the difference between working upstream and working downstream, what I'm curious about is how often do you actually get a chance to actually start working upstream to have the, resources and the opportunity and, oh, man, you know,
Inside HealthCore Clinic: Serving Needs Today While Preventing Tomorrow
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Teresa Lovelady: well, it's, health Core Clinic.
We provide access to medical, dental, behavior, health services, substance abuse services. We have a pharmacy in the clinic. There's a food pantry, there's a gym in the clinic. There's a walking path around the facility. We provide. Transportation for our patients. So many different things. So many education classes.
So as a community health center, we have to work on both ends of the continuum. Mm-hmm. So we're upstream and downstream. Mm-hmm. At the same time, because you can't ignore what's coming through the door. Mm-hmm. The pain that's coming through the door. But you do wanna go upstream and go, who's putting the babies in the water?
And what can we do to stop the babies from getting into the water? Mm-hmm.
Prevention in Action: Population Health, Pre-Diabetes & Early Detection
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Teresa Lovelady: One of the things, when I think about our [00:08:00] upstream work. We're at the point right now where we're looking at our population health, right? We look at all of our patients that we're serving and we really do try to create services and support for those that are not only our diabetic patients whose A one Cs are over a certain amount.
Yeah, but what about those pre-diabetic patients? Right? But what about going a step further and providing. That level of treatment and support and intervention and early intervention for all of our patients so that diabetes isn't an issue. And so we try our best at Health Core to make certain that we're not only serving like the diagnosis of someone.
Mm-hmm. But our vision is promoting a healthy community. That is truly our vision statement. And so we look at what's going on in our community and what are the things that we could do to make certain that we're preventing things. So that we're not having that costly cure.
Ed O'Malley: And I, I, I love that. And I just wanna remind people in case folks it's been a while since they've listened to the first [00:09:00] episode.
Just to remind, I wanna remind people about Healthcorp. So, Healthcorp is a federally qualified health center
Teresa Lovelady: Yes.
Ed O'Malley: Here in the northeast neighborhood of Wichita, Kansas, Nestle. Right. Really in the middle of a, a part of our state, a middle of a community that is facing the. Some of the greatest health disparities in our state.
So certainly right in the work, you're in the work and I love the way you just answered Susan's first question 'cause. You're a health clinic, so you're doing the downstream work, right? Somebody comes in and they got a sore throat or they've got whatever you're, you're doing the downstream work. You're treating symptoms.
Susan Kang: Yes.
Ed O'Malley: But you're also trying to model what it looks like to do upstream work. Which I think is important for, for listeners to understand and I, I think it's important for the 30,000 to understand. You know, there's a sliver of that 30,000 like you, Teresa, that are in the field of healthcare.
Producer: Yes.
Ed O'Malley: Most of the 30,000 aren't. And I think it's important for them to understand that the [00:10:00] folks most responsible for the downstream work have also for years been trying to do the upstream work. But you need more people helping you on that, don't you?
Teresa Lovelady: Oh, oh, yes. And, and when I think about, even if you're not one of the 30,000 that specifically work in the healthcare industry, health is.
Everybody's concerned. Mm-hmm. Because chances are you go to a medical provider, dental provider, behavioral health pro, like you're part of the healthcare system. for us to make certain that we are doing that upstream work so we can prevent the. When I think about it, the cost of going down too far downstream is death, right?
Yeah. Mm-hmm. Because if your health is so disastrous, your Big H and little H, so your health in your community, the health of your own physical health, if it's that bad, it's death or really horrible. Outcomes. Mm-hmm. Like you have a diagnosis and you don't have the resources to address it.
so when we go way upstream, what if I could prevent or identify or screen someone, like in our groundwater issue that we're having in northeast [00:11:00] side of Wichita, if I could screen you and use screen positive for cancer or at stage one,
Susan Kang: yeah.
Teresa Lovelady: I can prevent stage 2, 3, 4. And your life at stage one or two is, it's easier to recover that your chances are greater. Your mental health, the health of your family, the health. I mean, just imagine if we can go upstream and start identifying things before it's,
Susan Kang: that's early detection. Yes. Right. I hear early detection and also just the fact that you're, I wanna just go back to what you said, the way you described Health Core, the fact that you have a walking path around
the building that, that's going upstream.
Teresa Lovelady: Yes.
Susan Kang: Right. I mean, you are living that, like physically living. And it's an example of upstream work as far as I'm concerned.
Ed O'Malley: and I think it's so, the example about like screenings, cancer screenings, like that's another good example.
There are healthcare interventions that are more upstream versus more downstream. Mm-hmm. So like the early cancer screening is an example of going further upstream. Right. So we [00:12:00] start working on the cancer before it's way downstream, and then there are also.
Beyond Healthcare: Literacy, Community Factors & Everyone’s Role
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Ed O'Malley: Initiatives, efforts in the community that are outside healthcare. Yes. Right. So, you know, early literacy, I mean, the connections between whether people can read
Teresa Lovelady: Yes.
Ed O'Malley: And their later health outcomes is so clear, right? Oh,
Teresa Lovelady: yes. It's, oh, you know what's interesting there? We actually have a program at the clinic where we actually give every kid when they come in for their annual health screenings.
So we actually give them a book.
Susan Kang: Hmm.
Teresa Lovelady: They get a book, an age appropriate book, and they get to pick the book that they want. So we have kind of a mini library. They get to pick their books, so if you get a shot, you get your bandaid and you get some books. So I love it. There are so many things we can do in our community to go further up upstream and whatever work you're doing, just think about like, what caused someone to have to come to me
Susan Kang: Yeah.
Teresa Lovelady: And then start working there.
Ed O'Malley: What I love about the examples you're giving is you're a health clinic and you're working both [00:13:00] downstream and upstream. And you know, most of the people listening to this, most people reading this aren't health clinics. And so what we need you all to understand, those of you who are watching or listening, is we're not gonna climb the health ranking.
Just because healthcare professionals, lower H Health professionals work upstream and downstream, like that's not enough.
Frankly, the lower healthcare community, they've been working upstream and downstream for a long time. They've recognized that it's cheaper to prevent things than it is to treat things.
So they, like you all are on the cutting edge of so many things. And you're not the only healthcare facility that's working on both ends of that stream. Right, right, right. But we need the 30,000 to understand there's a role for them to play in working upstream.
Why We Default to Downstream: Ease, Feel-Good Charity & the Health Gap
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Ed O'Malley: And one of the things that I say in the book that is one of the more provocative lines is I mentioned that I've been involved in civic life in Kansas now for [00:14:00] 26 or so years.
I've noticed an interesting dynamic in Kansas when people who are already healthy become more concerned about the health gap, whether they use that term, the health gap or not, but when they become more concerned about the fact that some people are struggling and other people aren't.
Right. When they become more concerned about the health gap, they tend to gravitate toward downstream efforts.
Teresa Lovelady: Yes.
Ed O'Malley: Why is that? Why do we think that is?
Susan Kang: I wanna just point out for people who might have the book with me, 'cause I have my book with me that's on page one 20. And I wish, you know, I have that underlined as well 'cause that really struck me.
And the first thing that came to mind is, I mean, it's easier to do. Oh yeah. Right. It's easier to do. It's immediate
Ed O'Malley: feels good. It
Susan Kang: feels good. Uhhuh. There's sometimes there's a gala that goes with it. I mean, I'm just saying, you've got to get dressed up and, you know, and they give some money and you feel good and, you know, it's doing some [00:15:00] good.
But once again, that is just putting, you know, lipstick on a pig. How do we, what, what do we need to do to go upstream?
Ed O'Malley: Also, another thing I wrote is that charity, God, this is so dangerous to say, because I'm not saying we should reduce charitable efforts.
Susan Kang: Right?
Ed O'Malley: Right. We all, all three of us agree, but I wrote Charity Weakens the impetus to change the conditions that create the need for charity in the first place.
Right. Right. So like, and I think it weakens that impetus because. We actually do feel good. We feel satisfied. We feel like, okay, we're doing our part. Yep. I helped give out sandwiches to the homeless. I helped, you know, kind of collect coats for the winter for families who need coats. I feel good. I've done something and it kind of like releases the pressure though, to do.
To go upstream and find the who's own the babies in the river.
Teresa Lovelady: And I think sometimes it's the guilt associated with it. Huh? So if we are able to give what they [00:16:00] say, it's easier to give, it's better to give than receive, right? Mm-hmm. And when you do charity work, sometimes it's like, Ugh, I feel bad that this individual's in that situation.
Mm-hmm. So I'm gonna do this for them. when we think about charity, like nobody wants to be on the receiving end of charity because what does that say about. You. Yeah. If you're the one receiving that charity. So sometimes when I think about if when we go out and we're on that end and we're like, we did great.
Beyond Charity: Take One Step Upstream
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Teresa Lovelady: And we let me hoorah go, go and do, I mean, we have to go a step further and shift our mindset so that there is no need for that level of charity. So I would challenge individuals that are, you know, it's, it's good to be charitable, right? But what are the things that you can do besides handing out that sandwich?
So if you go upstream just a little bit, like take one step up if you're someone that's in a foster care field and you go out and your big brother, big sister, or something like that, you know, what's one step? What's the one other thing I can do to. Help make that kid not [00:17:00] even have to end up in the system.
Susan Kang: Okay. I love the one step up.
Teresa Lovelady: One step up
Susan Kang: because that's doable.
Teresa Lovelady: Yes.
Susan Kang: That is something that you can envision. That is something that's executable. And it can, you know, and then you can get to the next step.
Teresa Lovelady: Yes.
Susan Kang: Next step up. Right?
Why Upstream Work Feels Disruptive (and Gets Criticized)
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Susan Kang: Because here, here's what I wanna, I wanna also highlight. This is also on page one 20 head, you know, this is what makes sort of going up upstream a little difficult.
So what Ed writes is. And heading up river is different and disruptive. It's not the norm, it's provocative and might be misunderstood.
So
Ed O'Malley: yeah, I go, I go on and say, how dare you neglect the babies in the river. Right. You can be accused of neglecting the hungry person sitting under the bridge.
Susan Kang: Right?
Yeah. But, but
Teresa Lovelady: if you keep doing the same thing over and over, what is that the definition of?
Susan Kang: Right. Well, exactly. Well, you're certainly not gonna get different results, right? Right. I mean, we know this and so given, given that. Statement about, you know, it's not the norm, it's not the, it's, you know, it's not an easy thing to do.
In fact, you might be [00:18:00] vilified for it, right? Yes. So, under those circumstances, it makes me So to hark back to what you just said about what's the one step up, I feel like that is like a really sort of a bite-size. Yes. You know, bite-size in instruc, whatever. Advice that you can give to people who are trying to go upstream.
Right. Without it being overwhelming. Yes. And I love that.
Ed O'Malley: Yeah.
Downstream Is Tempting: Human Nature & Quick ‘Feel-Good’ Wins
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Ed O'Malley: I think it's, by this point in the book,
if people are, are still reading at this point or they're still listening at this point, they are. Of course they are.
Susan Kang: Who are you gonna say they are?
Ed O'Malley: Those who are. I think by now they are buying in to the idea that Kansas falling further than any other state in the health rankings is unacceptable, and they're buying into the fact that they might have something to do with that turnaround.
Okay. Right. And so I think, the thing that's crazy is most of these ideas aren't that hard. Like in part three, most of these ideas are [00:19:00] not very hard. Like holding an upstream mindset isn't really that hard to do. You just have to know the difference between upstream Yes.
And downstream. Mm-hmm. Think you also have to understand human nature is to do something. To feel good about yourself and your efforts as quickly as possible. Right? So like how do we tell ourselves a story at night that is, that allows ourselves to fall asleep, right? And tell ourselves a story that we did something good.
And you know, like passing out sandwiches helps me tell myself that story. You know, finding coats to give to families. So like. It's not that hard though. We just have to one. Know the difference between upstream and downstream. Yes. Know that people are predisposed to head downstream because. Is it, but why?
Is it because it's easier? Is it because it's quicker? Why? Why do we think? Why is the inclination to always head downstream, do we think? [00:20:00]
Teresa Lovelady: I don't know.
What It Takes to Swim Upstream: Org Pushback, Boards, and Incentives
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Teresa Lovelady: I mean, it's harder to swim upstream. Think about it. Hmm.
Ed O'Malley: Literally.
Teresa Lovelady: Yeah, it takes a lot of, it takes physical, mental, it takes a lot to try to. Go upstream.
And then while you're going upstream, you know, the criticism that you can get. And other organizations that do the work you do are going like, what are you doing? Why are you doing that? You're making us look bad. Mm-hmm. Or if you're in an organization that has a board, you know, you gotta get a whole bunch of people on board to say, I know I'm.
Host to count the people coming through the door. But what if I go outside of the door and keep people from coming to our door? Yeah. I mean, that's literally the work you have to do if you wanna go upstream. Yeah. So it requires you internally, within your organization to reshape and get ready for upstream work simultaneously.
Ed O'Malley: Okay. Yeah. So in the healthcare field. And I'm not an expert in healthcare, of course, but I, I'm smart enough to know that, there are conversations and experiments and, value-based care situations where mm-hmm. Providers, doctors, and so on and so forth [00:21:00] are getting rewarded in essence for doing upstream work.
Okay. Now that's taken a long time for that to happen, and we got a long way to go before it's actually in the system, right? Yeah. But I think what you're alluding to is the system forces in our society kind of push us, especially those in authority.
Right, to swim with the current, yes. Going down river in healthcare, there's a little bit of light maybe at the end of a tunnel about saying, well, let's actually compensate and reward providers who get upstream. But it's such a tiny little example. But in society overall, I think most of the 30,000 we don't get rewarded for going upstream.
We get rewarded for kind of keeping things moving. Right. Not causing too much trouble. Right,
Teresa Lovelady: right. Yeah.
Upstream Healthcare in Action: Screening Social Drivers & Real-Time Support
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Teresa Lovelady: And, and when I think about like, at Health Core, we actually screen for those social drivers of health. Mm-hmm. So when individuals come in, if you imagine going into your medical visit and you meet with a nurse and the nurse takes your vitals, well, [00:22:00] we take those life vitals as well.
So, and what that looks like is we ask questions about housing security, food insecurity. We ask questions about violence. Substance abuse, like all these other questions. So imagine your nurse asking those questions too. Yeah. And then in real time intervening with the support that's needed. Mm. we provide a second chance job fair at the clinic for our patients who, because we have their income information mm-hmm.
And so we engage employers in our community who are willing to give people a second chance. Mm-hmm. So bring in, you know, creating this space again, those safe spaces where you bring those individuals together. We encourage our individuals, our patients to enroll in classes at Wichita State because there are so many different types of scholarship opportunities that are available for people if you're low income and you can improve, your living status. And so we also engage our families in a way where it's like, are there some things that we can do for you and your family to make your [00:23:00] life better? And sometimes just having access within. And again, I'm in healthcare, having access, access for people to ask questions or to be a part of the process and to share what their thoughts or feelings are.
When I think about, going out and giving someone a sandwich. You know, I think about that person on the receiving end of that sandwich. Mm-hmm. What are they thinking? This person just gave me a sandwich so they get to go home and sleep, feel good about themselves when they go to sleep at night.
Mm-hmm. But that individual had a sandwich for that curbed their hunger for a few hours. So in our society we do have to, in Kansas, we do have to think. Differently about our charity work, our upstream work, and how we can truly impact and influence the lives of our neighbors. Because if what they say, if we rise tides, when all tides rise, it rises for everyone.
Susan Kang: Right?
Teresa Lovelady: And not feeling like we're not gonna like we do, we really need that feel good thing in that way. Or are we willing to delay that immediate gratification to go upstream a little bit [00:24:00] and do something that we may not even feel or see the benefit of that?
Susan Kang: So what resources do you think that they might need to.
Understand how they might start going upstream.
Practical Upstream Moves for Leaders: Budgets, Benefits, and Financial Wellness
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Teresa Lovelady: Well, I, I mean, mindset and mind. We control our mindset, right? We control our thoughts, our thinking. Okay. And that impacts so many other things. So again, going back before you hand the sandwich out in this example, what's something you can do one step upstream?
Mm-hmm. And then if you keep moving one step up, where are you gonna end up? And I think we can all start wherever we are, whether you're in a position of authority, right? If you're in that role, you can think one step up. So instead of just, you know, directing the team to create a budget can I be a little bit more intentional about let's make certain we include this, this, and this in our budget.
Make, make certain we look at employee wellness. Let's integrate a program where we're looking at financial wellness for our employees, because we know that, Alice. That's part of, you know, yeah. Yeah. It's, it's like limited income. So let's, let's help our employees [00:25:00] better understand how to value and invest and do things like that with money.
It's one of those where you can implement a retirement plan and maybe you're at 3%, 3% match. What would one more percent look like for that organization? So there are little things in different roles of authority or. Or while you're trying to experience leadership, you know, there are different things that I think each of us could do, especially if you're one of the 30,000 to start taking one step up.
And what if we all did it simultaneously? Like we all took that one step upstream at the same time.
Ed O'Malley: Yeah.
Influence Beyond the Field: Bankers, Electeds, Advocacy, and Collaboration Spaces
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Ed O'Malley: You know, I think there are a lot of people in the 30,000 who. Are heavily involved in some key issues, civic issues. So members of the 30,000 who are heavily involved in in homelessness. Know that to help our unhoused members of our society it, it starts before they end up under a bridge, right?
Like we've gotta go further upstream. Those who are working very [00:26:00] closely in literacy, you know, the principal of middle schools or elementary schools, they know we gotta get further upstream. I think maybe a message from this chapter is for the members of the 30,000 who aren't literally working. In some of these fields, You're the bank president and you're overseeing the charitable contributions of your bank. Mm-hmm. Okay. Yeah. So you're not like working in healthcare or in literacy or in homelessness, but you have a lot of authority and you're overseeing the distribution of charitable funds for your bank.
How do you shift more of those upstream? Right. Instead of just downstream for the elected official that didn't run for office because of these types of issues. Maybe she ran for office because she cares about promoting entrepreneurship and recruiting more high tech companies to want to be in Kansas.
Great. That's fine. Mm-hmm. But she still has influence over a whole lot of things that affect these [00:27:00] issues. And how does she think a little more upstream? I think this has been a really interesting Kuhn conversation, and it's one of those things where like, once people start talking about it, my experience has been it's not that hard to keep holding the mindset.
You just have to first acknowledge, yes, we've been going downstream. We gotta go upstream.
Teresa Lovelady: And disrupt yourself. You can't do what you've always done. So how do you self disruption, not destruction, but disruption. How do you disrupt your own actions and behaviors and thinking so that you can readjust reshift?
And when you do that as being one of the members of the 30,000, the ripple effect and the influence that you have. Something as basic as advocacy. Advocacy in some of these areas and advocacy is not too risky, right? Mm-hmm. You can go out and just saying something and, and just letting others know that you support.
The fact that we're gonna be number one and from what your perspective and your viewpoint, this is what this looks like for me. Yeah. And encouraging that mind shift, mind shift, shift mindset [00:28:00] shift in others. Yeah. Storytime Village, not sure if you guys knew about that. It's a new early literacy program and we're incorporating a clinic in there.
There's like a bookstore, there's a community convening space. So. Really when I think about how do we get some more collaborative upstream work. Mm-hmm. So putting that collaboration in there and then getting different organizations and different parts that impact health to work together is really creating those safe spaces or inviting spaces where we can bring in different groups and have them brainstorm about.
How do you serve in the field of early childhood literacy. Mm-hmm. Mm-hmm. And then someone serving in healthcare and then someone serving. Imagine the synergy that's created when you have those types of individuals working together. And so I think about those spaces across our state where we can create those convening areas where different factions can come together and have those.
Open conversations and see what comes out of that. [00:29:00] Health Core Clinic, being a community health center, there are 21 community health centers across the state. And we're all doing very similar work in our community. The fact that we are. Again, community health centers, we have to do things that really impact the, or address the issues and needs within our community.
Examples on the Table: Boardroom Questions, CEO Budgets, and Textron’s Model
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Ed O'Malley: Alright, Le, let's think just a little bit more about like, what can somebody do who's outside of healthcare? Like how can they put into practice these ideas of. What it looks like to hold an upstream mindset. So what types of things come, come to mind? Let's get some more examples on the table.
Teresa Lovelady: I, I think as a board member, if you're a board member or on an advisory group or within your community, just really challenging that organization that you're associated with to go one step.
Back, like think through your strategy and what you guys are doing and ask openly in a group, is this upstream work?
Ed O'Malley: I love it. Just like, literally ask,
Teresa Lovelady: ask
Ed O'Malley: it. And for our board from, for this nonprofit or what we've been talking about in this last meeting, has it been more upstream or more downstream?
Yes. That's, that's a great example. I [00:30:00] love it, Susan. What?
Susan Kang: Yeah, I mean, I think similarly if you're like a CEO of an organization, right? And as you're, making your, budget. Think about what that budget line item, is that an upstream issue or is that a downstream action that you're taking?
Ed O'Malley: Yeah, you know, it makes me think about like, like Textron Aviation here in Wichita, one of the state's largest employers. I mean, they get this idea. They get the idea that if we can work further upstream with our, with our employees. Employ thousands and thousands of people, it's gonna lead to better outcomes across the board.
So like they have implemented initiatives and policies and systems to make it easier for people to literally get healthcare on site if they want it. Right. Okay. They also make it easier though, for people to get a job in like a one stop shop. Yes for getting a job at Textron Aviation where people will help you learn what are your skills and how do we help develop your skills.
And it's kind of an example of Textron rather than Textron [00:31:00] complaining about the quality of the workforce. That's a downstream complaint, right? They are intervening further upstream to help people know how the jobs they can do and to upskill those people for the jobs they want. Teresa, I know we're winding up here in just a minute, and Susan, you always have a final question you want us to answer, but Teresa, one thing I wanna say before we let you go is community health centers do phenomenal work and really model the type of upstream downstream work.
Teresa Lovelady: Yes.
Ed O'Malley: We can't put it on your all shoulders.
Teresa Lovelady: Yes,
Ed O'Malley: and I think that's one of the messages of this book is that if we expect those who are the ones kind of most in the middle of the work like you. To be fully responsible for helping Kansas reverse the slide. It's just too much to ask. Right. You all face too many challenges, which is why we need more of the 30,000 to care.
Yes. More of the 30,000 to think [00:32:00] upstream. Yes. More of the 30,000 to take pride in the work of the community health centers in our state, but also know that as a bank president, as a Chamber of Commerce member, as an elected official. As whatever I am at 3000 every, I got a role to play. But anyway. So Susan, take us home here.
What's our final question?
Call to Action & Wrap-Up: Audit Your Giving and Shift Upstream
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Susan Kang: So the final question is, what is your call to action to our people who are still listening to this?
Teresa Lovelady: I would say, again, one step, step back, shift your mindset. Just start thinking just a little bit different. So you could start that journey of one step back, one step upstream in that way.
Susan Kang: What I'm gonna say is for those of you who are in the audience, who are members of 30,000, the next action you take, pause and figure out whether this is an upstream or a downstream action that you are taking.
Ed O'Malley: I think for me, I would take two minutes and make a list [00:33:00] of the charitable contributions that you can remember making in the last 3, 4, 5, 6, 7 months, and make a list of them and then just, right down next to each one, whether you think it was more upstream or more downstream. Hmm. And when I've done that with people in the past, what I've noticed is that people tend to have more downstream things. Yes. And that's okay. But part of the argument of this chapter of the book is we gotta keep doing the downstream stuff while we integrate more upstream.
So more to come. Theresa, thank you. Thank you guys for being a part of this journey with us. We appreciate you, Susan. This is good fun. We've got more chapters to go. And for our listeners and our viewers, we'll see you next time as we dive into the next chapter in part three, which is about working systemically.
Till next time, take care.
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